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tv   C-SPAN Weekend  CSPAN  August 16, 2009 10:30am-1:00pm EDT

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for engagement. i don't think these are representative of the people they know and the way the majority of the country feels. they're just angry, they're organized. and that's all fine. but i think they've become a little bit of a tool. on the other hand, though, i think that a lot of people in public and the politicians are looking at this process and saying this is chaos. health care is delicate and it is complex and i'm afraid about it. and how can something secure and good come out of of a process that appears to be this dominated by the extremes. so the town halls aren't trust worthy to people. they are doing a good job of delegislate miesing what's being done. and so the degree of politicians being able to say that isn't real and this is yet to be seen. >> will there be a bill this year passed? >> it's too soon to say. whether these are fabricated or legitimate, these may be the ones to vote in a couple of of
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months. and i think the angry pesh in the town hall is going to be in the back of the members minds when they come back in september to talk about this and vote about it. so if the town halls continue at the pace they are now, i would say it's not a good sign for this bill. but we have a month. that's a really long time when we're talking about a congress. >> last questions for you. would you give us your perspective on the committee we squssed on why the speaker has chosen to criticize? >> they poll terribly because they have the business model that is fundamentally not that productive. and she made a good point. she said it's very hard to compete in a way that's productive because then -- when you don't have ejir one in a system. they've become really quite hated and the political actors are simply acting on that knowledge.
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the insurance reform has podents because this is how you and i feel the system is bad to us and where we see it. our doctors help us, our hospitals help us. but the insurance people are the ones who argue with us on the phone for hours. >> thanks to both of you and look forward to your continuing reporting. >> tomorrow on washington journal, a look at president obama's health care plans with sam youngman of the hill. also jim martin, head of the 60 plus association on his organization's concerns with president obama's health care plans. and later, phil lip on the history of disease control and health practices. president obama was in colorado yesterday for a town hall meeting on health care. this event at central high school in grand junction is a
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little over an hour. >> sometimes people have forgotten what's transpired over the last sen, eight months. just six months ago we were in the middle of the worst recession of our lifetimes. we were losing about 700,000 jobs each month. economists from the left and the right, liberals and conservatives, feared the second coming of the great depression. i don't know if everybody rebs that. that was six months afplgte that's why we acted as fast as we could to pass recovery plans to stop the free fall. and there's been a lot of misinformation about that so let me talk briefly about what it is that we did.
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the recovery plan was divided into three parts. one third of the money, one third, of the money in the recovery act, the stimulus plan, went to tax cuts that are already showing up in the pay checks of nearly 2 million working families in colorado including right here in grand junction. of nearly 2 million working families in colorado, including right here in grand junction. [applause] so i just want everybody to be clear. one-third of it, tax cuts, not tax increases. more money in your pockets to spend as you wish. we also cut taxes for small businesses on the investments that they make, and hundreds of colorado small businesses have qualified for new loans backed by the recovery act, including 11 businesses in grand junction alone. [applause] that was one-third of it.
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another third of the money in your car react is for emergency relief for folks who have borne the brunt of this recession. we have extended unemployment benefits more than 150,000 -- for more than 150,000 colorado citizens. we have made health insurance 65% cheaper for families who are having to use covert because they lost their jobs and are out there looking for work -- myrrh having to use cobra. [applause] for states facing historic budget shortfalls, we provided assistance that has saved the jobs of tens of thousands of workers who provide essential services like teachers and police officers. if governor will tell you, if we had not had some of that money in, colorado would have had to make much more painful job cuts in vital services and i have had
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to -- might have had to put in place some painful state and local tax increases. that was the second and third of the recovery act. the last third is for investments that are already putting people back to work. there are almost 100 shovel ready transportation projects already approved in colorado which are beginning to create jobs. not far from here there is a project to pave and add lanes to state highway 92. most of the work is being done by local businesses, because that is how we will create jobs and grow this economy again. by next month, project will be underway at more than 100 national parks all over america, including colorado. [applause] these are projects improving jails -- improving trelliails.
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>> we saw old faithful. i had not seen it since i was 11 years old. it is sti going strong. tomorrow we will visit the grand canyon. i recently signed into law and public lands bill that designates the grand canyon as a national conservation area here in colorado. these are national treasures, symbols of how much we owe to those who came before us, and the fact that we are borrowing this earth from those who will follow as. i want to thank ken salazar, because he has been leading the way on these vital issues, especially in the west. as we grapple with enormous challenges like health care, the
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work of generations past reminds us of our duty to generations yet to come. there is no doubt that the recovery plan is doing what we said it would, putting us on the road to recovery. it is not solving all problems. unemployment is still way too high, but we just saw last week that the jobs picture is beginning to turn. we are starting to see signs that business investment is coming back. but that does not mean we are out of the woods. even before this extraordinary financial crisis, we had an economy that was working pretty well for the wealthiest americans, working freewill for wall street bankers, the big corporations, but it was not working so well for everybody else. it was an economy of bubbles and busts. it was an economy in which the average worker's wages and incomes had flat line for a decade. it was an economy that rewarded
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recklessness over responsibility. we cannot go back to that kind of economy. if you want this country to succeed in the 21st century, we have to lay new foundation for lasting prosperity, and health insurance reform is a key pillar of this new foundation. this economy will not work for everyone until folks like nathan and his family are pushed to the brink of bankruptcy by medical expenses, until companies are not slashing payrolls a losing profits to pay for health insurance. until every american has the security and peace of mind of affordable health care. health care touches us all in profound ways. it means is only natural this debate will be an emotional one. there's a lot at stake, and there has been a lot of attention paid to some of the
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town hall meetings going on around the country, especially those where tempers have flared. tv really likes that. you can have 20 rate meetings, and if there is one or someone loses their timber, that is the one that t.v. wants to cover. you have not seen the constructive meetings going on all of the country. that does not mean every one agrees with me on every issue, but it means we are trying to figure out what we know is an unsustainable problem in our healthcare system. [applause] just yesterday, i held a town hall in belgrade, montana, and we had a pretty good crowd. some were big supporters of reform. some had concerns and questions. some were completely skeptical. i got tough questions, but even though montanans had strong
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opinions, they did not shout at one another. they were there to listen. that reflects the american people and what our democracy is about, more than what has been covered on tv these last few days. that is why i thank all of you for being here today. i am going to take a bunch of questions, but before i do, i want to talk about what health insurance reform will mean for you. there is a lot of misunderstandings of there. first of all, what we are proposing is a common-sense set of consumer protections for people with health insurance. people with private health insurance. i expect that after reform passes, the vast majority of americans are still going to be getting their insurance from private insurers. we have to have some protections in place for people like nathan, people like you. so insurance companies will no longer be able to place an arbitrary cap on the amount of
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coverage you can receive or charge outrageous out of pocket expenses on top of your premiums. that is what happened to nathan and his wife. their son was diagnosed with hemophilia when he was born. the insurance company then raise the premiums for his family's and all -- his family and all the co-workers on the same policy. they were approaching the cap, and on top of pouring about taking care of their son, they had to try to find insurance that would cover them, plus thousands of dollars in out-of- pocket cost. nathan and his wife even consider getting a divorce so that she might possibly go on medicaid. thankfully, colorado's law does not allow coverage for small businesses to permanently exclude pre-existing conditions like his son's, so eventually they found insurance. they are paying increasing premiums and still have to face the prospect of hitting the new cap in the next few years. i heard from a teenager in indiana diagnosed with leukemia.
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the chemotherapy and intensive care he received cost hundreds of thousands of dollars. his family had a lifetime cap of less than a year. the insurance would not cover a bone marrow transplant, and the family cannot afford all the money that was needed. the family turned to the public for help, but the boy died before he could receive a transplant. if you think that cannot happen to you or your family, think again. almost 90% of individual health- insurance policies have lifetime benefit levels, and about one- third of family plans and individual insurance market have lifetime limits under $3 million. if you or your spouse or child gets sick and you had that limit, it is like you suddenly have no insurance at all. this is part of a larger story. folks with interests pay more and more out of pocket -- folks with insurance paying more unmarked out of pocket. premiums have doubled for the
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average family. nobody is holding these insurance companies accountable for these practices. your employer is paying even more, and you may not even see the cost of it except for the fact that you are not getting a raise. it is going into your health care instead of your salary and income. [applause] we are going to be an arbitrary caps on benefits. we will place limits on how much you can be charged for out-of- pocket expenses. no one in america should go broke because they get sick. [applause] insurance companies will also be stopped from canceling your coverage because you get sick or denying coverage because of your medical history.
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[applause] if you think this has nothing to do with you, think again. a recent report found that in the past few years, more than 12 million americans were discriminated against by insurance companies because of a pre-existing condition. when we get health insurance reform, those days will be over. we will require insurance companies to recover routine checkups and preventive care like mammograms and colonoscopy. that saves money and saves lives. [applause] at the same time, i just want to be completely clear about this. i keep saying is, but some folks are not listening. if you like your healthcare plan, you keep your healthcare plan. nobody is going to force you to leave your healthcare plan. if you like to doctor, you keep seeing your doctor.
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i do not want government bureaucrats meddling in your healthcare, but i do not want insurance company bureaucrats meddling in your healthcare, either. [applause] [applause] so just to recap, if you or one of nearly 46 million people who do not have insurance, it will finally have quality, affordable options. if you do have health insurance, we will help make that insurance more affordable and more secure. under the reform proposals we have put out there, roughly 700,000 middle-class colorado
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ans will have health care. 87,000 small businesses in colorado will be aided by new tax benefits so when they are doing the right thing for their employees, they are not penalized for it. and we will do all of this without adding to our deficit over the next decade, largely by cutting waste and ending sweetheart deals for insurance companies that do not make anybody any help there. another is some skepticism -- i know there is some skepticism. you know that lowering costs is possible if you put in place smarter incentives. if you think about how to treat
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people, not just illnesses. if you look at problems facing not just one hospital, but the many systemwide problems that are shared. now you are getting better results while wasting less money. i know that your center, michael bennett, has been working on legislation based on putting the innovations here in grand junction into practice across the system. there is no reason why we cannot do that. the fact is, we are closer to achieving reform that we have ever been. we have the american nurses association, the american medical association on board, because america's doctors and nurses know how badly we need reform. [applause] we have broad agreement in congress on about 80% of what we are trying to achieve. we have agreement from drug companies to make prescription
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drugs more affordable for seniors. $80 billion that can cut the doughnut hole that seniors have to deal with on prescription drug plans in half. [applause] the aarp supports this policy and agrees with us that reform must happen this year. because we are getting close, the fight is getting fierce. history is clear. every time wherein side of reform, special interest are fighting back with everything they have got -- every time we are in sight of reform. let's face it, they get people scared, and understandably. i understand why people are nervous. health care is a big deal. in fact, whenever america has set about solving our toughest problems, there have always been those who sought to preserve the status quo by scaring the american people. that is what happened when fdr tried to pass social security.
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they said that was socialism. verbatim, that is what they said. they said everybody would have to wear g tags, and that this was a plot for the government to keep track of everybody. when jfk and the lyndon johnson tried to pass medicare, they said this was a government takeover of health care. the same argument that is being made today. the struggles have always boil down to a contest between hope and fear. it was true when social security was born, it was true when medicare was created, it is true in today's debate. [applause] but whether you have health insurance or not, we all know we cannot continue down this path. costs are rising faster than
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wages. the system works a lot better for insurance companies that it does for america's families. to maintain what is best about our healthcare system is going to require change. we have to keep what is good about the system, especially the relationship between doctors, nurses, and their patients, while fixing what is broken. for all the scare tactic out there, what is truly scary is if we do not do anything. we will continue to see 14,000 americans lose their insurance every day. premiums will continue to skyrocket. the deficit will continue to grow, because most of it is medicare and medicaid. medicare will go into the red and less than a decade, an insurance woken -- insurance companies will continue to profit by discriminating against people because they are sick. if you want a brighter future, i
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need your help. i need you to stand for hope, knock on doors, spread the word, because we are going to get this done this year. thank you, grand junction. [applause] thank you. all right, now, i have time for a bunch of questions. we have a bunch of people in the audience with microphones. hold up your microphones, guys. the way we are going to do this is, i am just going to go around the room. to be fair, i'll make sure it is girl, boy, girl, boy. if you can introduce yourself and ask your question or make your comment. if you can keep it relatively brief, i will try to keep my interest relatively brief so we
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can get through more questions during the course of this event. let's see hands, and i will start with this young lady right here in the pink blouse. can you check that mike? does it work? >> good afternoon. i work at rocky mount orthopedics here in grand junction. i would like to extend an invitation for you to visit our successful practice to see how we provide excellent health care at a lower average cost to our patients. my question is, the regional healthcare house bill included funding for federally qualified health centers whose future budget would be based on expenses plus inflation.
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if private physicians, hospitals, and other providers are going to be given incentives to reduce waste and cost, what will be done to ensure the government programs will do the same? >> is an excellent question. -- it is an excellent question. what is so important about reform is that right now, the way medicare and medicaid operates, if it is starting to go over budget, you basically have two choices, either raise taxes and just keep on pay more and more, and health care inflation is going up at least twice as fast as inflation on everything else, or what we do is just tell the providers will give you less money. we will reimburse you 80 cents or 90 cents for every dollar of services you provide. and then what happens is that the providers in of discharging
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people with private insurance to make up for the difference. so that drives everybody's costs up. what has been done here in grand junction and other outstanding programs like mayo, they have started to change the delivery system so you are getting more bang for your health care dollar. let me give you an example. right now, if you go to your doctor and get a test, a lot of times, that test will not be forwarded to the next doctors are specialists that you have to see. you have to take another test. you might have to take three or four or five tests by the time your treatment is all complete. that is a waste of money, and if we can incentivize the provider to say do one test and then email the results to everybody who might be providing treatment or the patient might
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be referred to, that right there saves a lot of money. so what we want to do is to do this in medicare and medicaid, which will incentivize a lot of health systems around the country to start using some of the smart practices that you are using. frankly, medicare and medicaid provide a lot of care for a lot of patients, particularly seniors. if they hear from medicare, can you start doing things smarter, they have the incentive to do it. once they put a smarter system in place, the benefits spillover to the private insurance market as well. we want to do it through medicare and medicaid, but we also want to see in the private insurance market that health providers start thinking smarter and providing better care, which often turns out to be lower-cost care. it is not going to happen
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overnight, because a lot of these systems have been put in place for a long time. you are in grand junction or the mayo clinic or another good health care system, each year they are continually comparing notes. they have a peer review process where doctors are exchanging ideas, and they are continually making the system better and smarter, and over time, we can bend the cost curve so that instead of having inflation go a lot faster than everything else, it matches everything else. if we could just get health care inflation to match the inflation on food and other items, all of our long-term deficit problems would be solved. just that alone. if we could just reduce the amount of health care inflation, are long-term deficit problems would be sold.
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this is the most important thing we can do for deficit reduction. i want everybody to remember that, because in this debate, we have heard a lot people say we cannot afford to do this because our deficits and debt are too high. the biggest driver of our deficit and debt is health care. if we do not change the delivery systems and that some of the innovations that are being used where you work and in really good health care systems run the country, then we are going to be in red ink for ever. thank you so much for the question. [applause] the gentleman in the red irt back there. wait for the mike, so everybody can hear you. >> thank you, mr. president, for taking my question. i have been the health insurance
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business for over 25 years. i am a big steelers fan as well. >> are you allowed to confess that here? [laughter] >> you have asked many times why insurance companies are so afraid of competing with a public plan option of coverage. i understand insurance companies need to get spanked every now and then for sure, but if the public plan option reimburses on average 55 cents a contract of every dollar of care to the provider, the private insurance plans a contract reimburse an average of 85 cents per dollar of care, how could it be considered fair competition, and thank you for being here today. >> i think it is a good question.
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for those of you who have not been following the debate as closely, let me just describe what this issue of the public plan is all about. to do so, i have to describe how we are looking to provide health insurance for people wh currently do not have it. i spent most of my time talking about what we would do for folks who have health insurance, but we still have 46 million uninsured. i think it is the right thing to do to provide them with some help. most of them work, most of them are responsible, but their employer just cannot afford it because they do not have the bargaining power to get low enough rates to cover all their employees. that is a big category of the uninsured. what we have said is, let's set up what is called a health
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insurance exchange. it is essentially a marketplace where you could go online and you would have a menu of options. most of them private insurers, aetna, bluecross blueshield, insurance companies that want to participate. they will list a range of plans , just like when mike and mark want to get health insurance as members of the senate, they go on to this exchange for federal employees and they select which plan works best for their families. so we want everybody to be able to access that and choose which plan works best for them. they cannot afford it, even though we have a lot of bargaining power and would be able to get the same kinds of breaks that the big companies are able to get or the federal system is able to get, some people will still not be able to afford it, and then we would provide some subsidies. there would be rules that govern
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in the insurance company that participate. you cannot exclude for pre- existing conditions, you have to limit out-of-pocket expenses. all the insurers also talked about would be part of the deal if you wanted to sell insurance through this exchange. so far, so good. the argument around public option is, should one of the choices on that exchange be a public auction? the idea here would be that a government run not for profit would have its own option that people could sign up for. they would not have to, but they could sign up for it. it would keep its costs and provide good quality service and benefits, and that would help keep the insurance companies keep the insurance companies honest, because the idea being that as a not-for-profit, potentially with lower administrative costs, they could
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do a good job. the insurance companies have come back and said that is not fair, because nobody can compete against the government. they have legitimate points if what is being done is the government is either subsidizing the government plan and taking taxpayer money and saying we will just keep on spending money it regardless of whether you run a good operation and not. it is hard for them to compete against that. i have already said a public auctiooption will only work if y compete on a level playing field. the second argument that has been made is the one that you just made, which is if the public option is reimbursing at
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medicaid rates that are substantially lower than what private insurers have to negotiate for, then eventually private insurers might be run out of business. what has happened in the house bill, as has been modified, is they have said we will negotiate rates that will not be medicaid rates. that actually solves the problem you are addressing, because now this would be a negotiated process and prices would not be set just to medicaid. there's a third argument against the public option, the idea that we should not have government involved at all, that government is part of the problem, not part of the solution, to quote ronald reagan. we have some supporters of that view. i think you can have a legitimate position just saying
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you do not want to see more government involvement. i understand the argument. the only thing i would point out is that medicare is a government program that works really well for our seniors and has protected people -- let's not start yelling. it is true that it is expensive, but the truth is, the cost of medicare -- inflation has actually gone up at a slower rate than private insurance. it is not because it is mismanaged. is because of what was referred to in the first question. it is not a government per se. it has to do with the fact that the delivery systems are not working the way they should. if you just believe that governments should not be involved in anything, then you
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are right, you cannot support the kind of reform we are proposing. the only thing i want to make sure of is that you make an honest argument. nobody is talking about government takeover of health care. there is a difference between what we are proposing, which has some government involvement, versus the idea that somehow government is going to take over everything and get between you and your doctor. that is not what we are proposing. we can have an honest disagreement, but i just want to be clear on what the debate is about. it is about this narrow issue about the public plan. it is not about somehow eliminating private insurance. everybody who has private insurance that works for them will be able to keep private insurance under the proposals that have been made in congress. [applause] it is a woman stern. -- it is a woman's turn.
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>> i am a nursing student. as i am a potential health care provider, there are a few things in the plan that i read about that i wanted to understand more. as far as providers been required to report preventable medical errors in the health- care system, as far as health care systems are concerned, we are required to report every error we see, so i want clarification of how much you are expecting from providers in this system. >> different states have different rules, so we have kind of a patchwork. i confess i do not know exactly what the rules are here in colorado, but about 100,000
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people die every year from preventable diseases and illnesses in hospitals. some of the ways that we could solve this are so simple. there is actually a doctor who has put together a protocol, a lot of just basic stuff that cost no money, that has been shown repeatedly to cut these preventable illnesses and deaths down drastically by magnitude of 50%, 75% reductions in preventable deaths, just by applying these things that do not cost any money. so the question then becomes, how we get more hospitals, more doctors, more health systems to adopt these systems? the best way to do it is to make sure that not only are they
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reporting is preventable errors, but that they are also available to consumers, the american people, so that if they have too many of them come after while they start getting embarrassed. if you found out that there are two hospitals here in this city and one hospital has half the preventable deaths of the other hospital, you want to know that, wouldn't you? the problem is right now, often it is hard for consumers to get that information directly. so the idea is simply to make sure that that information is packaged in a way where you can comparison shop and your employer can comparison shop so that we are putting competitive pressure to improve quality across the system. that is what we are talking about. [applause]
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by the way, thank you for being a nurse, because we need more nurses. that is important. [applause] the gentleman right here in the t-shirt. hold on one second. >> thank you for coming to colorado. it is a great place. you touched on this and i would like to expand a little more. this problem with misinformation in our country. it seems to me that it is not only just starting health care reform, it is dividing our country. is it not may be time -- i think we all know where it is coming from. is it not time that -- i have to watch what i am saying. >> let me address this.
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health care is really hard. this is not easy. i am reasonably dedicated student to this issue. i have a lot of really smart people around me who have been working on this for months now. we have really fine public servants like senators bennett and udall who are working on this and thinking about a lot. the truth is, i want to be completely honest here, there is no perfect, painless silver bullet out there that solves every problem, gives everybody perfect health care, for free. there is not. i wish there was. i wish i could just say we are
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going to change the system, everybody will get as much care as they want, anytime they want, everybody will have a, and it will not cost anything. doctors will be happy and nurses will be happy, hospitals will be happy, insurance companies will still make a lot of profits, drug companies will be leveled the charges much as they want -- will be able to charge as much as they want. i cannot do it. nobody can. what i can do is try to sort through what are all the options available, be realistic about where we are going on healthcare, and say to myself, if we keep on doing what we are doing, we are in a world of hurt. we cannot afford what we are doing right now. more people will lose health insurance. more employers will drop coverage.
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medicare and medicaid will go broke. state budgets and federal budgets will be unsustainable, and then we will have to make some really bad decisions where we have no good options, even worse options than we have right now. what will end up happening is, mark my words, if we do nothing, at some point, in about eight or nine years medicare goes into the red. if we do not change the delivery systems and some of the incentives, we will have a choice. we will either have to cut medicare, in which case seniors will bear the brunt of it, or we will have to raise taxes, which nobody likes. and we still will be paying $5,000 to six dozen dollars more than any other advanced country in the world and not get better health care for. that does not make sense. in terms of misinformation,
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because there is no perfect solution, we can have a legitimate debate about the public option that we just had. that was a good, serious debate. you can make a plausible argument as to why we should not have it. i believe that we should. it is not perfect and will not solve every problem, but it will keep the insurance companies more honest. you can have an honest disagreement with the on that. what you should not do is start saying things like we want to set up death penalty to pull the plug on grandma. i mean, come on. [applause] first of all, when you make a comment like that, i just lost my grandmother last year. i know what it is like to watch
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somebody love who is aging deteriorated and have to struggle with that. the notion that somehow i ran for public office, or members of congress are in this so that they can go around pulling the plug on grandma? when you start making arguments like that, that is simply dishonest. especially when i hear the arguments coming from members of congress in the other party who, it turns out, sponsored similar provisions. here is what this was about. here was the genesis of this little piece of information. we had a provision in the house bill that would give the option of somebody getting counseling
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on end of life care our hospice care and have it reimbursed by medicare. the option, voluntary, so you would have more information about how to deal with these situations. it turns out the biggest proponent of this was a republican congressman who is a senator and colleague of mr. udall and mr. bennett. it turns out in medicare part b, which was passed by republican congress, they had the exact same provision. so when i had people who just a couple of years ago thought this was a good idea, now getting on television, suggesting it is a plot against grandma or to seek -- to sneak euthanasia into our system, that feels this honesty. we have enough stuff to deal with without having these kinds of arguments.
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[applause] it is a woman's turn here. i have neglected this area. the lady there with a black dress. >> i am a small business owner from colorado springs. i am also a republican that voted for you. [applause] >> what is your business? >> we make software. >> excellent, we need that. >> i hope so.
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i grew up in a blue-collar family, and my husband and i work very hard at our small business. we have always treated our employees like family, given them great benefits, any time of the need with their family. i volunteer in my professional community and my children's schools, and that is still not enough, because we are on the cusp between middle-class and the rich. we are going to bear the brunt of what this is going to cost. why is what i do now not enough? >> let me talk about both cost and what this would mean for small businesses, because both issues would affect you. first of all, remember what i said, i cannot come up with a perfect solution that is completely free. it is absolutely true that in order for us to provide help to those who have no insurance at
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all, that is going to cost some money pyrrhic is going to cost some money. we cannot do it for free. it is 46 million people. that is going to cost money. what i have proposed is going to cost roughly $900 billion. that is a lot of money. keep in mind, is over 10 years. when you hear some of these figures thrown out, it is over 10 years. let's assume it is about $80 billion a year. it turns out that about two- thirds of that could be paid for by eliminating waste in the existing system. let me give you one particular example. right now we provide 107 $7 billion over 10 years, about $18 billion a year to insurance
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companies in the forms of subsidies for something called medicare advantage, where they basically run the medicare program that everybody else has, except they did extra money that they make a big profit on. -- they get extra money. there is no evidence at all that seniors are better off using medicare advantage than regular medicare. if we could save that $18 billion a year, that is money we can use to help people who need help right now. so about two-thirds of what we are talking about is paid for through the existing health care system, money that is already being paid by taxpayers. it does not require additional taxes. that still leaves one-third. in order to pay for that, there have been a lot of proposals out there. one of them that i proposed, i
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still think is the best idea. you may disagree, because i do not know what your income bracket is. my proposal was that for people making more than $250,000 a year, people like myself, that we should, instead of getting the full itemized deduction of what our highest tax bracket is, we should just kept out are itemized deduction at 28%, which is what the average american gets. my attitude is, i should not get a bigger tax break by write a check to my local church and if the janitor down the street right to check to their local church. we should get the same tax break. if we were willing to do that, just that alone would pay for what we are talking about. some members of congress disagree with that and they have other proposals. that is going to be worked out in september. i do want to make the point that i have not proposed any plan
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that would put the burden on middle-class families in order to deal with this. when you hear people talking about i am raising your taxes, the only tax policies i have implemented for middle-class families is a tax cut for 95% of working families. let me talk about small businesses. i do not know your particular situation, whether you are providing health insurance to your employees. if you are, then you stand to benefit from this plan, because every proposal that has been put forward provides a huge number of subsidies to small business owners that are doing the right thing by their employees. it is very likely -- obviously we would have to look at the calculations and figure out how many employees you have etc.,
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but it is more than likely that you would actually make money, gained from this plan, because you are already providing health insurance to your employees, and we would give you some help. the only category of folks who might not like this plan are employers who can afford to provide health insurance to their employees but are not doing so. what we would then say to them is, we are giving you affordable options. you are going to be able to be part of a bigger pool. you can buy your health insurance through that its change was explained to that gentleman there. you'll be able to get premiums and prices that are comparable to what big companies like xerox or ibm are getting for their employees. we will give you some help doing it, but if you refuse to provide any health insurance for employees at all, then we are
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going to ask you to make a contribution to help make sure those employees have health insurance. it turns out, if you as an employer are not providing that health insurance, the rest of us are, because those folks are going on medicaid or they are going to the hospitals for uncompensated care, and that is not fair. [applause] so the bottom line is this, if you are a small business person who is providing health insurance for employees, i am very sure that you would actually benefit from this. the problem is, this is where the information has not been going out in as clear a fashion as possible. that is why i am glad you asked the question. i am going to call on this gel
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and because he shouted at me a couple of times. -- this gentleman. i am happy to get a good debate going. >> i am a student at the university of colorado in boulder. i am studying political science and business marketing. i would love to have a debate anytime, oxford style, if you would like. my question is this. we all know the best way to reduce prices in this economy is to increase competition. how in the world can a private corporation providing insurance compete with an entity that does not have to worry about making a profit, does not have to pay local property-tax this, there are not subject to local regulations. how can a company compete with that? i do not want generalities' or
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philosophical arguments. i am just asking a question. >> thank you for the question. i just want to point out that i partially answered the question earlier by explaining that certainly they cannot compete with the taxpayer is standing behind the public auction just shoveling more and more money. that is certainly not fair. i have already said i would not be in favor of a public option of that sort, because that would just mean more expenses out of our pockets and we would not see much improvement in quality. it is true that there are certain costs associated with a private business that a government would not have to worry about. it is not just property taxes, it is also things like the cost of capital, insurance companies
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have to have a lot of money on hand, and it is conceivable that a private entity that is having to pay a certain interest rate for their money would be really undermined if the government is able to get money much cheaper, implicitly because of sam backs this operation. -- of all salmon backs this operation. this is actually a -- uncle sam backs this operation. i think we can craft a system in which you have a public option that has to operate inpendently, not subsidized by taxpayers. it would be nonprofit, but we already have not for profits out there like bluecross blueshield. they would have to go on the market ended a market price -- and get a market price. there are ways we can address
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those competitive issues. if they are not entirely addressed, then that raises a set of legitimate problems. the only point i wanted to make was, the notion that somehow just by having a byoption you have the entire private marketplace destroyed, is just not borne out by the facts. fact, right now you have a lot of private companies that do very well competing against the government. ups and fedex are doing a lot better than the post office. the larger point want to make, and it is good to see a young person who is very engaged and confident challenging the president to an oxford style debate. i think this is good. [applause] i like that.
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this is a legitimate debate to have. all i am saying is that the public option, whether we have our region not have a, is not the entirety of health care reform. this is just one sliver of it, one aspect of it. it is both the right and left that have become so fixated on this that they forget everything else, like the fact that we can help make the make sure that he does not suddenly find himself completely broke in trying to treat his son. we are working on a series of proposals to address the questions you are raising. i believe that we can work them out, but those are specific questions as opposed to broad, philosophical questions about
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whether government ever has a role to play or not. this is the last point i will make. you have a bunch of countries that have systems in which government is involved, but you still have a thriving private insurance market. the netherlands is a good example. everybody is covered. the government has regulations in there, but it does not somehow take over the entire private insurance market. i just want people to understand, nobody is talking about a government takeover of health care. i want to repeat that one last time. i have time for one last question. i am going to call on this young lady right here. she just lost your question. who has a microphone?
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>> i cannot believe that we have the president of the united states of america in grand junction, colorado. [applause] we are so proud of you. >> thank you. >> i am a naturalized citizen, and i am proud to be an american. [applause] as a child, i had polio, and i have had 52 surgeries to correct my bones. between here and the mayo clinic
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in phoenix arizona, i have been blessed with a good insurance, generally excellent doctors and care. however, my major concern in costs, even with good insurance, and has been high, when i have been gone out of the network. why should our doctors' treatment choice be limited by a geographic area of the state? what kind of competition is this, mr. president? . this raises an important question and goes to the overall debate out there. when we talk about reform, you
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hear some opponents say that somehow we are trying to ration care or restrict the doctors you can see, or you name it -- well, that is what is going on right now. if is just that the decisions are made by the insurance companies. in fairness we probably could not construct a system in which you could see any doctor anywhere in the world any time, regardless of expense. that would be a hard system to set up. if you live in the state of maine will fly you and to california, put you up, -- i mean you can see, and i'm not trying to make light of it -- but you can see the difficulty. there will have to be some choices in in the system we design. have to be made in terms of what is going on, etc. that is currently being done in the private marketplace.
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all we are trying to do is to make sure that those decisions being made in the private market place are not discriminating against people because they are already 66 -- 6 - sick, and making sure they get a good deal. if you go to a hospital, you get one of those operations you discussed, and it turns out that two weeks later, a europe got to be readmitted because they did not do it right the first time, the hospital has to pay penalty, or at least they are not as much reimbursed. the more we make those kinds of changes, the more likely it is
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that more americans have more options and they are not being jerked around. it does not mean everything will be perfect, but it does mean consumers have more choices, better options, more security, more protection. that is all we're trying to accomplish, and we're trying to do it in a way to reduce costs overall for families, whether you are getting medicare, medicaid, or private insurance through your employer. i am confident that we can accomplish this, but we will have to work hard and overcome some of the misinformation, we will have to have an honest debate. nothing will be perfect. we are going to have to make sure -- this is something people need to understand -- even if things go perfectly and we pass legislation, let's say, in october, we are still going to have another three months of debate about this and several
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years of implementation. it will not happen overnight. we will have to set up these reforms to give insurance, and i hope everyone understands that. we cannot tell companies to take everybody if you have a whole bunch of people who are healthy and young to choose not to get insurance at all. because then, insurance companies will just take people when they get sick. then it will go into the office, they will say, give me insurance, a the company will lose money pretty quick that way. if we will limit the pre- existing conditions problem, we also have to do that with the coverage problem, so this will
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have to be phased in over a number of years. the last point i want to make, and this has to do with the budget issue, because we have a huge deficit right now and the huge debt and i think that is coloring how people view this debate. i hear people saying, how can we afford this right now? we've got to use our resources for the deficit. first, i want everyone to understand the source of our deficit, because if you do not understand that, argument will not make sense. when i walked into the white house, i have people waiting for me at the door, a 1.3 trillion dollar deficit. 1.3 trillion dollars. i say that -- this was not -- and this is not, by the way, entirely the previous administration's fault. the financial crisis was so bad that revenue plummeted and all
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of this money was spent in making sure that the banking system did not completely collapsed. so all of the actions that have been taken just spite the deficit. but the problem actually is not that -- the extraordinary steps we've taken over last one or two years. the real problem is much longer. even if we had no fiscal crisis whatsoever, we have a structural deficit, we are spending more money than we're taking in, we have been doing it for the last eight years. when we passed the prescription drug benefit for medicare by a republican congress, they did not pay for it. they did not want to pay taxes, but it wanted benefits. that just went right into our structural we did not pay for.
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we get a structural deficit that, over the course of the next 10 years, is about nine trillion dollars. i say that, because i want everybody to understand that if you're going to tackle that problem, the only way we can do it in an intelligent way is if we get control of medicare and medicaid spending and some realistic way. if we do not do that, we cannot simply tax or cut our way of the problem. ask some times in audiences what people think the amount the federal budget is devoted to foreign aid. people say 20%. if we just cut that out, we
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could eliminate deficit. it is 1% of our budget. 1%. people think it is all this pork project and your marks. 1%. all are spending a social security, medicare, medicaid, interest on the national debt. interest on the national debt. everything you think of as a government program, that is only 25% of the budget. the rest is social security, medicare, medicaid. medicare and medicaid are really
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going up fast. if you are fiscal hawk, a deficit hawk and are tired of this crazy spending in washington and you want to finally make sure we're looking out for the next generation, then you more than anybody should want to reform health care. because of we do not do it we cannot solve the problem. thank you, grand junction, love you. ♪
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>> the president last night in granges and camaraderie. earlier today kathleen sibeliu'' suggested that the white house is ready to accept coops and says there should be a choice and competition, but a public option is not the essential element. -- last the was the president and grand junction, colorado. >> now look at some health care ads. the first is from a consortium including the ama, that supports the president's plan. that is followed by a u.s. chamber of commerce at that opposes the proposals. >> what does health insurance reform meat for you? it means you cannot be denied coverage for pre-existing condition or drop if you get sick. it means putting healthcare
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decisions in the hands of you and your doctor. it means lower costs. it means new rules to cut waste and red tape, and a focus on preventing illness before it starves. what does health insurance reform really mean? quality, affordable care you can count on. >> washington's latest health reform washington's- $1 trillion plan and a government-run public option with big tax increases, even on health benefits -- and the federal deficit? it is said to grow $239 billion. swelling deficits, and expanded government control over your health -- tell congress of let's slowdown and reform health care the right way. >> now senator chuck grassley at health care town hall from united methodist church in ohio. this is one hour, 10 minutes.
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[applause] could i ask a favor of you? when people raised their hands you could call on them? >> i would like to be a first question. >> you can do that, too. >> as long as i can be first. [laughter] >> this gentleman will ask the first question. i will make a few remarks before he asks the first question, but then he will stand up here because i do not want anyone to think i want to avoid taking questions from anybody. there will be three times as many people raising their hands as we will have time to answer questions.
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so, if you get mad because you don't get your question answered, get mad at him, not me. >> the proposition was made only if i got to ask the first question. [laughter] >> the other thing is that i want to thank the methodist church for opening up their facility for us. [applause] methodist church for opening up their facility for us. [applause] i have been in the city hall here in afton before and it was big enough, but there are many people understood and we want to accommodate as many as we can. i want to say that the last time i was near the pulpit of the methodist church except as a person sitting in the pews, is
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that i used to get a lot of invitations to speak on sunday for the sermon. i suppose they wanted to find out if a person politics could be a believer in jesus christ. [laughter] but i always used to speak toii corinthians 5:17-21, about how being saved at through jesus christ, it takes the responsibility of spreading the word about jesus christ and of those sorts of things. but i have not been asked to do that lately, so maybe -- maybe i'm not much of a preacher, but prior to 10 is a god thati bet that i did it six or seven times per year. we're here in the first place because you know my policy of getting to every county every year to have a town meeting.
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you are the 2844th town meeting i have had since been in the united states senate. [applause] and i have two more scheduled and i have been in 71 before today. some things i have been doing on health care reform are reflected in what i have learned from iowans or the past few months i have hearheld those 71 meetings. that have held a 71 town meetings. also, we are here with such a large crowd because people fear for america. [applause] i believe is a culmination of things that the health care issue has brought to a head,
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nationalization of factories, banks, things of that nature, debts that are tripling over the next 10 years if we stay on the course we are on. people are concerned about the future of the country. i never thought this would have voted on all these issues in january and february and back in the time when i voted against the stimulus bill and the bailout and the appropriation bill, and the four trillion dollars budget that was adopted that will triple the national debt, but i would be -- 08 to beat holding these town meetings if i had voted that way. before you ask the first question, i would just like to say a little bit -- first of all, we will take questions on any subject. this does not have to be health
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care. if you want to bring up other things, bring them up, because i will let you set the agenda. we are having these large turnout because of the health- care issue. there has been a lot of concern expressed about what my views might be and what i am doing in washington, whether i am listening to the people of iowa and those sort of things. first of all, i express to you that i think we have the best healthcare system in the world. it does not mean is perfect. -- it does not mean it is perfect. there are things that could be improved. some people have a hard time getting health insurance, and it is awful expensive, and a lot of other things you can say. my goal, the principles i go by, and i will not express all the
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principals in the opening here, but some of them will be expressed in response to your questions or my listening to your comments. i am not going to do anything that is going to nationalize health care in america. [applause] i do not intend to do anything that will allow government bureaucrats to get between you and your doctor. [applause] i am very concerned that we do not do the things that lead to rationing, like what happens in other companies were the government runs things. i am particularly concerned about government as they did in england putting a dollar amount on life, so that the older you
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are, the less health care you might get as opposed to somebody younger. i think that every life has value, and i think that we want to make sure that if you like the health insurance that you have, you ought to be able to keep it. i do not want a government-run plan, because i think that is a step in the direction of a canadian-style health care system, based on studies that have been done that people will be crowded out and premiums will go up. saying you have the government running everything. i believe that is something we
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can legitimately fear. they'd need -- they use the word that we need competition. i see government not as a competitor but as a predator. from that standpoint, we have to be careful about taking that first step. i am telling you that i am not for that, but i hope most of view -- i have been on television so much this year that you have heard me say that before, so you do not think time pandering to you to say it now. i know you are what all working hard to pay taxes and doing what you have to do to support your family and you probably do not watch as much television as i think you do. so i want to state that again
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for you. . . just in case you wonder, well, i don't know what you read in the papers, but you get some places. chuck grassley is sitting down with a couple of other republicans and two or three democrats to talk. talking is finding where you can find common ground. raise the you what to do that -- i hope first of all that you know i am not one -- well, listen, if i were doing at the last five months i could stand around with my feet up on my desk, i guess. sitting with my feet up on the desk. i think you hire me to keep on top of this. you will be on top of things if you are in the room rather than
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outside the room. you have to realize -- you study this in government. we have the checks and balances system. the congress checks the president. the president checks the congress, but within congress under a two-party system, one ought to be making the other responsible, otherwise they are not doing a job. that is even more true in the senate for you have to have a super majority. it gives minority some rights. the republican minority is not a very big one now. the democrats have 60 votes. there are a lot of democrats who have questions about things other democrats want to do. sometimes by working together you can bring some sensibility to it. if you cannot, then you just
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save what is not right about it and fight it that way. but it seems to me that there is nothing wrong with talking -- i have nothing to worry about because of you heard the president in his town meeting in portsmouth, new hampshire, he was kind of hinting that he is about ready to ask his people in congress to go ahead with the stricter partisan bill anyway. so, if that is what he wants to do, he can. i'm not walking away from the table, then i am being pushed away from the table, see. so, i figure you pay me to do my job and these are the principles i use. -- these are the principles that i use when we talk and make a firm agreement. maybe cannot.
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the way i do things, there is no agreement until you have a total agreement. that is where we are. i think i am ready to take your first question. i am interrupting you. [laughter] you are going to see me taking notes here. it does not mean i'm not paying attention. if i do not write something down, by the way, if anybody wants to hold me up i have enough wire -- look at all these. i could be a terrorist in baghdad. [laughter] i'm going to take notes on every issue that comes up. >> this is not directed at you personally. you can fix the health care crisis by doing one of two things, eliminate the 11 page 31100 page document that congress will not read or understand and get everybody in
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this room the same health care plan that covers congress. [applause] it that is not agreeable, then we will like everyone in congress or all elected officials to be under the same health care plan that we are. if congress cannot do that, you are at the you root of the problem that is distressed, lack of integrity and do what is best that america. do not tell us what is right for our health care plans.
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my goal was not to have a government plan because it is the first up towards having a canadian-style government-run health care, but if there would be a plan like that adopted, i think congress should be part of it. let me say why. not because i'm here to look good to you, but i need to give the background were i did something similar 13 years ago in 1995. it took me about five or six years to get it done. for the 60 years prior to that period of time congress had passed several laws affecting you as business people, minimum- wage law, civil rights laws,
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safety laws -- probably 15 of them. we are employers in congress. congress exempted itself from every one of those as they adopted them at different times. so, i thought, how can i represent a particularly small business? big business can take care of themselves. if i do not have to abide by the laws you have to when i hire people and a work area that you call an office, see. ocea never came to my office to look at safety issues. we had two sets of laws, one for the rest of the country and one for coupled. i got the government accountability act passed 1975in -- in 1995, so those laws ought to apply to congress as well. [applause]
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>> thanks for being with us here today. i have a question about cap and trade. in the. . . are you willing to support that? are you willing to strengthen other standards independent of cap and trade? >> i know the cap and trade. i knew the renewable portfolio standard issued. what is your question? what is your question? if it was independent of cap and trade? >> the answer is renewable portfolio standards would say as a matter of policy. a certain amount of electricity
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from renewable sources like wind comics cetera. the answer is it i would support it at a 15% rate. someone -- some people want 20%. i support 15%. the further it out it isike 25% or 20% is more astute. i have voted twice in the past four years for that. i am for a renewable portfolio plan. does that enter your question? -- answer your question? >> i have more of a statement. when 9/11 happened, i was terrified but i'm more terrified now. i thought my government was going to protection. now i'm afraid my government. banks are taken over. now a i reading now i feel our
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health care is taken over and we are moving -- now i feel our health care system is taken over and we are moving toward socialism. >> i can listen to more people. how can you and the other conservatives control them? >> what can conservatives in congress do about the things that she fears and she has mentioned, a trend toward socialized medicine that she used examples of general motors and banks and things of that
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nature. what can we do? we are in the minority. it makes it very difficult. sometimes people think it is not going exactly right. that is assuming republicans are sticking together. it seems to me we have two responsibilities. one come to see if we can change programs that are way far out so that they are getting bipartisan support and changing them. if he cannot do that or even if they are changed not enough, then you have to expose what
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they are and you do that through debate and you do it through your no vote. if you are going to be irresponsible minority, then you have to have today a response walleye more -- if you are going to be a response to a minority, you have to have something to say. i alluded to the president that he alluded that he wants to go to his own way. then we are in a position to think the things that we think can improve our health care system. there are conservative senators as i can work with in regard to that. the chances of getting it adopted a probably not very good unless turnouts like this
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changes the mind of mbers of the majority party. eventually, every two years to have an election and an opportunity to express your views and there are significant times when the elections and make consequences. we are finding that out right now. you can study history and find out that people change their mind from time to time. >> i've heard 40 million uninsured people. 10 million of that is another i have heard. that includes illegal immigrants. that is 30 million. that is only 10%. but will have to answer of a
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problem, why do we fix that 10% as some of overhauling -- if we only have 10% of a problem, why do not we fix that 10% and some of overhauling the entire system? >> i think to make a good point. -- you make a good point. it is based on the proposition that more things ought to be done. one of those principles is to make sure that people that do not have insurance have insurance. you are zeroing in on those. depending upon what these town meetings mean to different congressman that if a comprehensive program does not go through or cannot get through, then you will find some incremental changes along the lines of what you are suggesting, more a day rifle shot approach as opposed to a
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shotgun approach. i'll tell you why people in congress are already concerned about it. there are others that have come to the conclusion that maybe some of the things of your being proposed and not good. i had one senator that i will not name him i did not expect him to say that. >> who was that? >> i will not give you his name. i think a private conversation should be kept private. he said to me as we were going to vote, he said we need to slow things down. he is not in the negotiation. we need to slow things down. he said we need to do things more incrementally. that would be, you did not use
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those words, that is what i would say. in other words, dealing with one problem here as opposed to 100 problems is what you are asking us to do. >> yes. >> what can you do to get the government out of our lives and let this use our god-given abilities and talents to make things better for everyone?
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>> i suppose the easiest answer would be to just not vote no. i think there are certain things out there that you would like to have repealed. i have found it easier to cause programs from not getting larger and not establishing programs that i have found it to do away with older programs. being a person that wants to limit government, i have found the best way to do it is through the taxing policy. if you limit the money coming in to the federal treasury, then you are going to limit what can be spent to some extent. you are still having overspending. but i do not by the principal --
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but i do not believe the principle that a $1 increase in taxes results in a $1 decrease in the deficit. it results in probably $1.20 more being spent. if you want government to be less intrusive, then the tax policy i think is the best way to do it. that may also be because i sit on the committee that has jurisdiction over taxes. my principle is to keep taxes where they have been on the 40 or 50 year average. i do not have charts to show you, but it would be easier to explain with them. when we had higher tax rates with kennedy and eisenhower or
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when it was lower with reagan, now is 35%. if this president gets his way will go up to 39.6%. i could show you that on a 40- year average, about 16% to 18% or 70% or 19% of gross national product comes through the government for the 495 members to decide how to spin it instead of you deciding how to spend it. i am chairman of the senate finance committee. we have the biggest tax cut in the history of the country, the 2001 tax bill. we are back down into that range of 17%-19%. i think that is the best way to keep government from being interested.
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i would like to thank you for your integrity. and for sticking to the principles of the constitution and the bible. i would like to have you know that you are in our thoughts and prayers. i think this country really needs it. i see a parallel between what happened in the early 30's in germany and what is trying to be done by the leadership of this country now. step by step, there is overtaking of the freedoms and the choices and the privileges of this country. we have the health care reform bill, the water bill, one that limits the freedom of speech by the broadcasters.
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we have the cap and trade bill. one is being run by the house. white house and said the country. country. it is outrageous it is outrageous. in the bill, are the words " navigable waters" being changed to "water" so that the government will has jurisdiction over all water in the united states? >> the answer is yes. i need to go into this a little bit deeper because this is a complicated issue. by the way, i am against that bill. by the way, she said that she prays for the people in government regularly. i pray for president obama every day. we have a responsibility to pray
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for the people in government. all you have to do is read 2 timothy 1 and 2. it tells everyone of us that believe in christ that we need to pray for people in government. one time at lunch, i told the president that i prayed for him. anyway, let's go back to this issue. in 1972, there was a court decision that restricted -- that gave the army corps of engineers control over almost any drop of water that fell any place. in 1978, i was in the house of representatives. we changed it, but not very well. it was not enough to protect private property. they got in the last 10 years, we have had two or three, maybe four, supreme court decisions
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that have restricted the army corps of engineers to what are termed as navigable waters. that is a legal term that says that if an ocean-going ship or a ship of a certain size can go up the river, as far as the kingdom of the river, that is under the control of the army corps of engineers. private property, want to take the word unnavigable out. -- navigable out. yet the pedal of water and bureaucrats can come in and regulate it. -- you have a puddle of water and bureaucrats can come in and regulate it. that was a problem i had with judge sodic my door. i think she made some decisions -- said judge sonia sotomayor .
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i think she made some decisions that did not show some respect for private property. that was one of the reasons why i voted against her. [applause] can you come a little closer, please? if you cannot, i will come closer to you. maybe you should hold it for her so she can read. >> obama says people will have a choice and they can keep the insurance they have, but it was mentioned that on page 16 of this bill that it does not give that choice. i am confused. this is under the grandfather health insurance coverage.
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the individual's health insurance issuer offer such coverage and does not enroll any individual in such coverage. it is the first effective date of coverage on or after the first day of y1. what is y1? >> y1 would be the first year the bill would take effect. >> insurance companies cannot take on new people after that time? >> i have said the part of that bill. i am not sure i can comment on that. i can answer your question where i am coming from. i think it means what you fear, but i do not know for sure and maybe if my staff wants to chime in on this. but me see what i can answer without my staff helping me.
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what the president said during the campaign is in danger, not because he has changed his mind, because people in congress have a different thing that they want to accomplish. it goes to this public option thing. that is only part of it. that is an important part of it, because you heard me say before -- they say 120 million people will opt out for the government- run plan. then you have 170 -- any have about 50 million left. premiums will go up. pretty soon other people drop out. it makes the president's promise actually unworkable. if you are going to have a government-run plan that people get into. the other one which is in the house bill that you are talking
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about that, this may be part of what you are reading from, i do not know for sure, in the house bill there was a law passed in 1974 that gives companies that are self insured exemption from state mandates because they operated across the nation and internationally. they are exempt. in the house bill does away with that exemption in five years, which i read -- but i do not want to be taken word for word, because i have not studied it. i'm not a lawyer. john deere, after five years, would not have his plan. that is the way i read it or any other company that is operating under this. those two things lead me to
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believe that under -- after a certain time, you are not want people to keep your health insurance if you like it. if i do not hear from my staff, i'm going to want to the next question. if i am wrong -- >> [unintelligible] >> that is the bill. i'm going to vote against that. i'm not in favor of that. >> so far, i can hear you. >> we have not yet heard on the senate bill -- we have not yet heard of the senate bill being placed. when did that come into play?
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what are you looking at for out of pocket caps and lifetime caps coming with the bill's being presented to us? >> i can answer that. for our committee, we are still talking. we may not reach an agreement. we are talking about not having any cap at this point. the other bill is a senate -- the kennedy-dodd bill. i am not sure i can tell you exactly what they do. if you are asking me they do not know about the bill, they voted it out of committee. they do not want to print it because they do not want to reading it between now and labor day. it is not scored. the congressional budget office has not given in a score. we kind of thing there is
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subterfuge their. if you found out how much it might cost, it would double the size of this room. >> what about orphan drugs? my medications would cost over nine and a thousand dollars. my out of pocket with a full- time job requires me to have a part-time job. we are looking at the out of pocket caps so that we can afford to keep the [inaudible] >> i think our policy is somewhere in the neighborhood of 13% to 15%. again, i want to make it clear that we are talking. there is no bill ready.
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>> i have been a practicing pediatrician for 55 years. >> why don't you hold it for him? he has to talk with his hands and you moved it away. >> 20 of those years were spent in a medical clinic. i am the lone survivor of that clinic. i was on the board for 16 years. every single blue cross-blue shield board in the country was nonprofit. we ran an operation with the team doctors, with highly skilled business people. the director was paid $75,000. 93 cents of every dollar paid and was paid out as [inaudible] now, there's not one single blue cross-blue shield organization
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in the country that is not for profit. wellmark used to beat the blue cross-blue shield. the retiring president got an extra bonus of $8 million. i noticed that the head of aetna has a salary of $15 million. i have a couple of others written down but i cannot find them right now. they are making so much money. we are spending twice as much per person as any civilized country with health insurance. to the best of the figures i have seen, i was going to say something but it jumped right out of my mind. our country ranks 12th in health care.
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in longevity, we are 12. in maternity rates, we're 12. a newborn and fatality rates, we are 12. in general, we ranked 12th. we are not first. their 45 million people that do not have insurance. something has to be done about insurance companies and their rates and profits. [applause] because of health reasons with my wife, i had to move to the state of texas. in south texas, our hospital delivered 300 babies a month. if they had medicaid, they were fine. if they had a good insurance, they were fine. when we would have our monthly pediatric meeting, the result is about 30 to 35 people that came into the emergency room in labor never having seen a doctor. in this country, i think that is
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ludicrous, just ludicrous. i am enough of a libertarian that i think it is hard to legislate morality. they tried to do that with alcohol and it was a total failure. even now, alcohol causes more problems than all of the drugs. together -- and all of the drugs. together. all drugs were legal until 1923. after that, they became illegal. now there's lots of murder, robbing, all sorts of gang wars. drugs are cheap if they were made legal. the court would have 50% less cases. the prisons would be emptied by about 1/3. all of that money could be used to rehabilitate the people who
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did overuse the drugs. my last statement is that afghanistan is a total quagmire. england tried for 10 years to do something with it. russia tried for 10 years. then we sent troops and people on the border to train the people we're not fighting against. as soon as any kind of creation can occur, we need to get out of afghanistan. i have a lot of that in a letter that i will pass on. >> the key. [applause] -- thank you. [applause] >> he did bring up something that prompted me when he used the word medicaid. medicaid is a state and federal program. it is completely government run. it pays so little that we have a massive number of doctors that
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will not take medicaid patients. we're getting in that boat kind of and a lot of places either in the inner cities or rural america with medicare. it ought to give you some judgment about how much more you want the government to get involved in medicare. with medicaid -- or with medicare, there is the factor of about money not being spent wisely in the united states. there is a statistic the evening get from an annual study put out by dartmouth university. they have been doing this for two or three decades. if the costs were like they are from washington to new york state and from kansas north to canada, we would save 1/3 of our health care dollars.
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we would save them. there would be in the medicare fund to make medicare last longer than it is. some of those are related to a simple things like how doctors practice medicine in iowa. they do a good job of it. their fourth or fifth in the nation in quality. -- they are fourth or fifth in the nation in quality. if people are sick, they may not go to the doctor. the doctor does not sink to the hospital at the drop of a hat. they do not send you to a dozen specialists. those sorts of things really add up in the cost of money. getting back to what you said about taking care of the eight or 10 million people that do not have insurance and zero in on that. then we need to zero in on other things were money we're already spending is not being spent
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wisely. wisely. why do not you come over here and stand by me? the issue of the uninsured and people that have pre-existing conditions. i think that is a larger problem in this country than the uninsured. you cannot get coverage because of that. i am curious what your thoughts are about how to solve that problem. >> that is a very good question. i'm sorry i did not touch on that in my opening comments, because it is one of those things that i think there is almost a consensus in washington that when we are dealing with health care that we
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ought to do away with the discrimination that comes from pre-existing conditions and then connected with it, we have this wide-ranging of high to low. we are going to narrow that down closer. between the high premium and low premium there will not be a big difference. in this particular instance, where we have been talking at this time is not to set up several insurance departments. we will continue state regulation of insurance, but we will do it through what we call preemption. federal law will preempt state law or override state law in these areas where they would allow pre-existing conditions.
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>> to me afford insurance companies to continue [unintelligible] is that not going to increase everyone's premiums? >> the extent to which we deal with this business of the uninsured and having insurance, that brings more revenue into the insurance company. >> i am just trying to figure out what did this. but it is one of the most difficult issues we have to deal with. it is one that is not even settled at this time. it is something that fits in with the american principle of individual responsibility. it is like the state if you decide to drive a car, and you have an individual responsibility to have car insurance. >> a few moments ago you said
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this bill, a john deere would not have health care. >> i did say that now. >> a few weeks ago you said you want better health care and you should work toward a john deere or the government. why would you predict them to lose their health care? >> you understand that i would not be for the provision that this lady brought up that i talked about. i do not think the exemption ought to be done away with. then he would keep the john deere insurance. go back one step in that into question. i am not for doing what the house of representatives is doing. >> i work for the electoral corporate jet. -- a cooperative.
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[unintelligible] we have a real concern would be hr2452 climate change a bill. our concern is for individuals or members that there of victorville's, you being from iron ore -- electric bills, tubing from iowayou being from a [unintelligible] i want to know if you are for the bill as it is and what this congress doing to make sure that electricity remains affordable and reliable and we can provide it? >> this is a bill that would increase your utility tax very directly every time you turn on the light switch it increases
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costs. everything you buy the goods three manufacturing process would be affected when you increase the cost of energy. this puts a real cost and the american family. it might be phased in between the year -- now in the year 2020. it to be major in three years and gradually ramp up to even more. the way it passed the house i would not vote for. that may not be the bill that comes up in the senate. there is not a bill out of the committee yet. i think we have until the end of the year to worry about this and work are members of congress. they are working on me about the issue. it think it is one to be issued a difficult for them to get some sort of a compromise -- i think it is going to be difficult for them to get some sort of a compromise. i would like to answer your question about where i am coming
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from and not going to vote for a bill and i do not know what it is it does not tell you much. with the house bill, if you have a problem within the united states was not a level playing field. the midwest and southwest are dependent upon cole and it is going to come out of this very badly. in new york and california, they are going to come out of it relatively well. the may even make a little bit of money. -- they may even make a little bit of money. when you go united states by itself, if the rest of the world is not follow along, we need to go ahead and be the moral authority for the other nations -- suppose we are uncle sucker instead of will stand and where the only ones that and of doing it. then we have a very unlevel playing ball. how ironic it is that the ones
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that are outsourcing manufacturing jobs to china over the last 10-years for some the same people promoting cap and trade for calling it cap and tax, because that is really what it is. i do not want to unlevel the people for america, particularly when the director of theuta says if the united states doesn't by itself it will not do much. -- does it by itself it will not do much. i turn my tangent to copenhagen in december. there are international negotiations. i do not know how to get china and india to come along. if they will go along with it and we will not lose all manufacturers to china -- you understand china is in number one emitter of pollution, not the united states. they do not want to do it.
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india is even more adamant about doing it. then we lose their jobs. we need to get china under the umbrella and it takes a 2/3 vote in the senate to get it done. i think there is some protection for our consumers and interesindustry. >> glad to see you again today. i am a veteran. i am very proud to be a veteran. [applause] i belong to the american legion. in order for a person to be called a veteran that has to serve in the military, there are lots of people that are called
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veterans that cannot belong to the american legion. congress after world war roman one set up the american legion. is the largest veterans' organization in the world. we have a lot of people. in order to belong to the american legion, you had to be in the service during a war. we had a lot of people that after correa, vietnam, world war i, if they are still alive, that not able to belong to the american legion. it is up to an act of congress to change that. we as the american legion can change that. i was just wondering if maybe you would introduce a bill to
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have that change. >> i'm going to do this. if you would let my staff have your name and address, and i want them to tell james on a washington staff to call you said you can be in the background. quite frankly when you started out to talk, i was thinking in terms you are going to ask me -- i thought only the american legion made this determination. if you are right about congress doing that, we have done it since i have been in congress, i do not remember that. i want to know what there is about that and in the controversy is connected with it and maybe i will do what you want to say. i do not want to tell you that until i steady. i hope he did not get mad at me i do not do it. -- until i studied it. i hope you will not get mad at me if i do not do it. s>> if people can have
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five or 10 minutes and express their concerns without an answer. why do not we open it up for that for about five for 10 minutes? and not know how much more time we have. but my staff says there is one more question. i think what is being fought here is that i take too long to answer a question. i would be glad to just listen. >> [unintelligible] some of them are very highly controversial. they have really radical views. i do not understand what we see in those people.
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>> 44 czars that have been appointed to the white house. the lady is opposed to it. >> it is good to see you. thank you for being here. i appreciate folks from union county be here. i came up with eight questions. it is been narrowed down to if you. in your conversation, since the president did single you out as being one of the people willing to talk about various provisions, these something's out by to ask you. in your conversation, is there any provision for a person to purchase their own health insurance? is there any provision for the individual to establish health savings accounts and for a tax incentive to do so?
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is there any provision for tort reform would add substantially to health care costs? is there any guarantee that abortion or other life ending procedures will not be paid for by u.s. taxpayers? the other thing that is frustrating me is that why is health care reform getting some attention and the president's attention when the jobless rate is the greatest current threat for our family? [applause] >> one of the things in this whole controversy that scares me so much is that when you hear the obama sound bites, his advocacy of the current idea of keeping your health insurance sounds very much like you. it scares me to death that there is so much misinformation
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around. we do not really know what is happening because of the terms and debate. nobody can argue with what is being said because all they have done it is said that he will keep your own insurance and do this and that. and yet, when you get to reading the bills, that is not what it says. >> my question has to do with the upcoming census and the apportionment that is based on the senses. -- based upon the census. the us census is done by the federal grant. the apportionment is done by the legislative branch. will there be equal representation after the next one? >> not unless we amend the senses laws -- the census laws
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that they only kill the people who are legally here. >> congress counts only the citizens and not all the people. >> statistics come from beingcensus. -- come from a beingcensthe cen. >> [unintelligible] there has never been made in the comment made about this. it is h.r.45. [unintelligible] this would make us report our fire arms on our income tax
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statements. it to make it have to pay taxes, about $50 each on our firearms. there is a top provision clause on page 16. guns must be locked and put away and gives the government a right to come into your home at any time and check things like this outcome. this is an encroachment on their second amendment. this is so sneaky because they will sneak it in on the internal revenue act of 1986. this can be passed by the finance committee without anyone voting on it. i am opposed to anything that encroaches on their second
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amendment rights. -- on our second amendment rights. >> i am too. i am, too. >> you pointed out several times that there are states to run the coast that cost a lot more for medical care. i am for it to under the thousand dollar cap on it. it as a medical -- $250,000 cap on it. it will save medical companies a lot. >> a clinic a comment about tort reform that will probably not be done. @@@@@@@@@ @ @ @ @ @ @ @ @ @ @ @
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>> i am a farmer. [applause] >> my question is with regard to the inspector general's better part of each government agency. i know recently the president fired one without the 30-day waiting period after he started investigating one of the friends of the president. do we not have any policing of the government agencies? >> let me answer that. the law that should have applied if he was going to be fired, the president had to give a 30-day notice and notify congress. did you know that senator obama was an author of that bill along with me? he forgot about it after he got elected.
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that person is suing. what we have is a bigger problem with inspector general's that we have to watch the administration on. there are bills in to have more presidential appointments of inspector generals instead of having the department head appoint them. i use inspector general germans to sleep in my oversight work. i get more fraud and mismanagement sorted out by working with the inspector generals. i'm going to fight hard to make sure that they maintain their independence. [applause] one more question? >> it seems appropriate since we are in the united methodist church to let you know that the united methodist church is the second largest protestant denomination. at their last general conference, they are in favor of the public auct in help --
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they are in favor of in favor of favor ofo the public option. the united methodist church believes that healthcare is a right of all americans, all people living in the united states. health and hold this is indeed a right of all people in the world. -- health and wholeness is indeed a right of all people in the world. it should not be auctioned off to the highest bidder. much of the money from the health care bureaucracy goes to an advertising and to maintain the health care bureaucracy that seems to be almost as large as the government bureaucracy. you need to know that the united methodist church of the last general conference voted for a public option as one of the options for health care.
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>> thank you for telling me. we have to go. >> we would all like to thank senator grassley. [applause] [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> if you mandate health care companies to carry everyone, will that make everyone else's premiums go through the ceiling to cover everyone that they have to cover? >> we will give a tax credit to help people under 300% of poverty.
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[unintelligible] >> there is someone here to meet you. >> do you know what insurance plan has the highest to the minister of costs in the country? medicare. yes, it does. that is a proven fact from the government budget office. they have the highest administrative costs of any plan. not only that, they are running out of money. >> we are listening to different sources. i get a lot of different numbers. >> health care now! >> nobody listens. we jump up and down. we get excited and we raise our voices. we raise our hands. we write letters but no one will listen. when we start getting excited, in a manner of speaking, they
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are radicals. you did not listen to us with letters and telephone calls. what does it take to get you to listen to as the first time? >> health care now! >> i would like to see health care for everyone. i want to see affordable health care for everyone. there is a population that is not out here. everybody out here it probably will to do and have insurance. there is a population that is not here that has a voice that needs to be heard. i am in the health-care field. i came out to hear them speak about the bill. but i did not get that. i am kind of disappointed in that. i wanted him to really address the issues and answer some of the questions on a national level, not where people cannot
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sit down and recognize what he is sane. >> i feel it is an unfair issue. i am against abortion. as a nurse, i would have to perform abortions against my own rights. i feel that is very, very, very unfair. it is about the government taking control of our lives and telling us when we can get treatment, what kind of treatment we can get, and what is going on in our lives. >> i am against what they're going to do in congress right now as far as medical health care and the socialized health care they are proposing. it is a huge takeover by the federal government. that is not good for anyone. >> if you want to call it socialism, i think it is better than what we have now. my turn. >> i was born in cuba. you cannot get an aspirin in cuba. i sneaked in pounds of medicine every month. they cannot get medications.
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you can see the pictures of human feces on the ground. >> i lived in spain, which is a socialist country. the health-care system worked perfectly. i lived there for five years. [unintelligible] >> sorry, i am not going to show you what i know. i lived in spain. people were taking care of from birth to death under a fair system. it does not cost anybody anything. >> where does the money come from? >> folks from the surrounding area have come to talk about national policy. that is a powerful thing. we may not agree or disagree with everyone that is here. the congressman is working his way through talking to as many people as he can. we scheduled this in january. this is our august meeting. we do this every month. this is our 52nd one since the congressman was elected. this is by far our largest crowd
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by 10 or 11 times. that is great. >> the government has no business taking care of what i can take care of on my own. >> we have become -- in other countries, they're people just died. they do not have health care. we need to have proper health care for everyone in the united states. this is the way to start. nobody says it is perfect. we have to start someplace. this is a good place to start. >> as congress continues its summer recess, we want to hear from you. are you attending a town hall in your community? what do you think about the various proposals being debated? share your experiences and thoughts with us on video. >> this fall, into the home to america's highest court. from the grand public places to those only accessible by the nine justices.
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the supreme court is coming the first sunday in october on c- span. >> next, a hearing on wartime contracting and whether reconstruction and security contracts in iraq and afghanistan are being properly reviewed. this is two hours and 35 minutes. >> i would like to call this hearing to order. i am the co-chair on the committee on contacting. i will make an opening statement on behalf of the other commission members.
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mr. teebo will provide the joint opening statement tomorrow during the hearing on linguistic support services in theater. we have panel members with us today. congress established this commission by statute in 2008 as an independent, bipartisan body to examine a wide range of issues relating to wartime contracting to extract lessons learned and make specific recommendations to improve structures and practices to promote achievement of national objectives, and to reduce waste, abuse, and fraud in contracting. we are hard at work to fulfill the mandate. the commissioners and our professional staff are conducting hundreds of interviews, carrying out intensive research,


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